Our prior U.S. Pat. No. 5,505,728, whose contents are incorporated herein by reference, describes a novel electrosurgical electrode for ablating or shrinking throat tissue in a surgical procedure. This is accomplished by an electrosurgical electrode activated by electrosurgical currents that is applied by the surgeon to the patient.
Our prior U.S. Pat. No. 6,447,510, whose contents are incorporated herein by reference, describes a novel electrosurgical electrode for the treatment of benign and malignant lesions of the upper aerodigestive tract. This is accomplished by an electrosurgical electrode activated by electrosurgical currents and configured such that it can be applied by the surgeon to the patient via the rigid cannula of a laryngo-pharyngoscope. The electrode is stiff and specifically configured for this particular procedure.
Our prior U.S. Pat. No. 6,231,571, whose contents are incorporated herein by reference, describes a novel electrosurgical handpiece employing an extendible/retractable electrode operable by the surgeon for manipulating the working end of the electrode to reach treatment sites that may not be more directly accessible. The examples given include spinal surgery.
Our parent application, the contents of which are herein incorporated by reference, describes the use of a micro-fibre electrode, a very thin, flexible electrically-insulated wire, typically about 1 mm or less in diameter and a length of about 475 mm or more, that will fit down a working channel of an endoscope and thus access patient sites not easily reachable with ordinary electrosurgical electrodes, such as the larynx, or for snaking through a vein. The micro-fibre probes when used with RF electrosurgery are highly suitable for the selective, superficial removal of mucosal lesions and providing a sound specimen for histological examination and providing the least amount of collateral injury. This is very advantageous along with significantly reducing the costs for these procedures and greatly reducing scars and synechiae.
There is still a need in the art for devices to simplify the treatment by MIS of tissues more easily reachable than with the electrodes described in the referenced patents. These include, among others, epidural scar tissue, adhesions and other pathology, spinal diseases such as intradiscal shrinkage or ablation, endoscopic endonasal procedures, as well as treating internal tissues reachable only by, for example, being snaked or threaded up into a vein to travel up to leg lesions, etc.
Specially designed small knives and micro-scissors are available for traditional tissue ablation in the larynx and trachea. However, their disadvantage is that they require expert manual skills and rigorous practice, and in addition frequently result in diffuse bleeding at the surgical site, obscuring the operative field and making it difficult to access the progress of the surgery. Powered instruments (micro-debriders, shavers) have been used, in which tissue is excised by a rotating blade and aspirated out of the sheath, but there is a high risk of tissue damage and tissue may be chewed up rapidly and cannot be evaluated histologically. Lasers such as the CO2 have become popular for use in endoscopic surgery of the larynx and trachea. Their disadvantages include combustion of ventilation tube materials and anesthetic gas mixtures during laser use in larynx tissue destruction and alteration, complicated safety precautions for doctors, staff and patients (ie. protective glasses, bouncing of the laser beam off metal instruments causing inadvertent burns) and possible electrical hazards, eye and skin injuries, as well a steep learning curve for doctor and staff, and their high price.